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目的:探讨小儿气管支气管软化临床特征及纤维支气管镜对小儿气管软化诊治价值。方法:对常规治疗无效的持续咳嗽、喘息或反复下呼吸道感染的120例患儿行纤维支气管镜检查,观察其气管支气管管腔变化,并对镜下有感染灶者行灌洗治疗。结果:共诊断气管支气管软化20例,按部位分类为总气管软化9例,气管支气管软化10例,支气管软化1例;按病因分类为原发性软化症19例,合并喉骨软化6例,会厌软骨软化1例,先天性心脏病1例,气管狭窄1例,气管食管瘘1例。继发性软化症1例,存在管外压迫;按严重程度分为轻度软化11例,中度软化8例,重度软化1例。年龄为3月～5岁。结论:气管软化临床表现无特异性,多表现为反复咳嗽、喘息或呼吸道感染,早期行纤维支气管镜检查可以提高诊断准确率,避免误诊及漏诊。
Objective: To investigate the clinical features of pediatric bronchoconstriction and the value of fibrobronchoscopy in pediatric tracheal softening. Methods: A total of 120 children with persistent cough, wheezing or repeated lower respiratory tract infection who were ineffective in conventional therapy were examined by fiberoptic bronchoscopy to observe the bronchial and bronchial changes of the trachea, and lavage treatment was performed on the patients with the lesions under the microscope. Results: A total of 20 cases of tracheobronchial softening were diagnosed. Nine cases were classified as total tracheal softening, 10 cases of tracheobronchial softening and 1 case of bronchial softening. According to the cause, 19 cases were classified as primary softening and 6 cases with laryngeal softening. 1 case of epiglottis cartilage softening, 1 case of congenital heart disease, 1 case of tracheal stenosis, 1 case of tracheal esophageal fistula. 1 case of secondary softening, there is pressure outside the tube; according to the severity of mild softening in 11 cases, moderate softening in 8 cases, 1 case of severe softening. The age of 3 months to 5 years old. Conclusions: The clinical manifestations of tracheal softening are nonspecific, with many manifestations of repeated cough, wheezing or respiratory tract infection. Early fibrobronchoscopy can improve the diagnostic accuracy and avoid misdiagnosis and missed diagnosis.